A new option for overnight contraception?

Only two forms of “overnight” contraception are approved by the Food and Drug Administration, the two hormonal drugs taken orally in pill form: levonorgestrel (Plan B One-Step and other brands, available over the counter) and ‘ulipristal acetate (Ella, available by prescription). Observational studies strongly suggest that a non-hormonal copper intrauterine device (ParaGard) may also be effective.

Now, researchers have found that another type of IUD, the one containing the hormone levonorgestrel (Liletta and other brands) works as well as the copper IUD, and possibly even better than oral pills approved by the FDA for prevent pregnancy.

The study, in the New England Journal of Medicine, tested the copper IUD against intrauterine levonorgestrel in a randomized trial. Researchers recruited 638 women seeking emergency contraception from three family planning clinics in Utah, randomly assigning them to one device or the other.

After one month, there was no pregnancy in the women who used the copper IUD and one of those who used the hormonal IUD. The researchers calculate that the incidence of pregnancies with intrauterine levonorgestrel is 0.3%, compared to 1.4-2.6% with oral contraceptives.

None of the intrauterine devices are now approved for emergency contraception, but the study’s lead author, Dr. David K. Turok, associate professor of obstetrics and gynecology at the University of Utah, expects professional guidelines to include them soon.

“The bottom line is that this is another option that can be very interesting,” he said. “We now have a well-designed and executed study that shows it can be used.”